Dr Kevin Lally

Doctor – Registrar

Dr Kevin Lally is a Specialist Trainee Doctor working in the Midwest of Ireland.  His special areas of interest are Liaison Psychiatry, Addiction Psychiatry and the areas of overlap between physical health, mental health and addiction. He is currently involved in research in dual-diagnosis/co-occurring disorders and the management of addiction issues in General Hospital Emergency Department settings. In the future he hopes to improve knowledge and understanding of addiction issues in both psychiatric and general medical settings and improve services available to people experiencing dual diagnosis.

Aims:

Primary: Evaluate adherence to national guidelines for Hepatitis C screening and referral for treatment in a large drug treatment clinic

Secondary:

Prevalence of Hepatitis C and Hepatitis C co-infection with Hepatitis A, B, and HIV

Methods:

Cross sectional prevalence study

All patients attending the NDTC during month of May included (n=496)

Standards:  HSE clinical guidelines for Opioid Substitution Treatment, National clinical guideline for Hepatitis C screening

Outcome measures: Documented virology, Referral to Hep C treatment team, Documented review of pharmacological interactions between Hep C treatment and regular medications

Interventions: 1 Hepatitis study day attended by MDTs, Laboratory arrangements made to allow screening outside of regular hours, Process for obtaining patient written consent to release serology records from when tests performed in other clinical sites

Results:

There are high rates of screening for HIV, Hep B and C in NDTC (>80%)

The majority of patients have positive virology for Hep C (56%)

33 patients have been treated in the NDTC for Hep C since Jan 2018 with 100% compliance and 100% SVR (sustained virologic response)

Findings: Factors influencing sub-optimal adherence to national guidelines are multi-factorial relating to client, system and personnel factors

Conclusions:

Multidisciplinary team working is required to provide a complete service to patients and service users

The presence of an on-site Hepatitis treatment team  with access to DAA treatment is highly advantageous to service provision and beneficial to service user

Re-audit 6 monthly cycles

Co-Authors

Mr C Mullen, Medical Student, University College Dublin Aileen Singleton, Clinical Nurse Specialist Hepatitis C, Yen Yee Lee, Pharmacist, National Drug Treatment Centre, Dublin 2 Dr William Flannery, Consultant Addiction Psychiatrist, National Drug Treatment Centre, Dublin 2 Dr Shay Keating, Associate Medical Specialist, National Drug Treatment Centre, Dublin 2

Conflicts of interest:

n/a